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NPI Code Detail

MEDICARE: ELYSE RAYBUCK CRNA

MEDICARE: ELYSE RAYBUCK CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist4704168343MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598795320
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELYSE RAYBUCK CRNA
Provider Business Mailing Address
First Line : 3340 CIRCLE DR
Second Line :
City : COMMERCE TOWNSHIP
State : MI
Zip : 48382-1957
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 36475 5 MILE RD
Second Line :
City : LIVONIA
State : MI
Zip : 48154-1971
Country : US
Telephone Number : 734-655-2022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 04/10/2026

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Directions to “ ELYSE RAYBUCK CRNA” Practice Location

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